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Mammogram Frequency Should Be Dependent On More Than A Woman’s Age

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I read the LA Times article by Shari Roan, Study urges more individual mammogram guidelines, with interest.  As Roan notes, guidelines to date have mainly focused on a woman’s age and not her other risks factors.

The American Cancer Society recommends that healthy women undergo screening mammograms every one to two years beginning at age 40 regardless of risk factors. In 2009, the U.S. Preventive Services Task Force recommended a different schedule which urged the inclusion of an individual’s personal risks:  screening for women ages 40 to 49 should be based on individual risk factors and women ages 50 to 74 should be screened every two years.

Monday, a paper was published in the Annals of Internal Medicine (full reference below) which argues for a more personalized approach to screening mammograms.

The study by Dr. Steven R. Cummings, senior author and senior researcher at the California Pacific Medical Center Research Institute, and colleagues was based on a computer model comparing the lifetime costs and health benefits for women who got mammograms every year, every two years, every three to four years or never. Read more »

*This blog post was originally published at Suture for a Living*

Obamacare Unraveled: What Could Possibly Go Wrong?

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It is hard to remember all the defects in President Obama’s Healthcare Reform Act at once.

President Obama’s Healthcare Reform Act is so flawed it cannot possibly work as it was intended. It must be repealed. A serious, thoughtful, practical and common sense way to “Repair The Healthcare System” must be enacted before all the stakeholders have adjusted to President Obama’s coming changes that will create a more dysfunctional system.

A reader sent me a photo of a poster hanging in his local ice cream store. It is a reminder of previous criticisms of President Obama’s Healthcare Reform Act.

Harrys ice cream 2

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*This blog post was originally published at Repairing the Healthcare System*

American Heart Association’s Registration Page Demonstrates Gender And Sexual Orientation Bias?

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This afternoon I sat in my chair, revitalized form my weekend trip to the Jersey Shore, where I can assure you I did not partake in any fist pumping, spray tanning, pickle eating, or felonious activities, when I received an email from the American Heart Association announcing new scientific findings. I like these emails and generally find them informative.

This particular email announced the placement of the first completely lab-grown human vascular grafts. The email linked to a presentation from Todd N. McAllister of Cytograft Tissue Engineering Inc. These blood vessels were apparently engineered from donor skin cells and: Read more »

*This blog post was originally published at On Becoming a Domestic and Laboratory Goddess*

CMS Hospital Readmission Penalties And Their Looming Unintended Consequences

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Beginning next year, if you or your loved one is discharged from a hospital, you’d better not return to it for 30 days. That’s because the hospital may be fined for your readmission (especially if you have had pneumonia, heart failure, or a heart attack – diagnoses singled out by CMS as preventable causes of readmission). In fact, if your readmission happens to tip the scales into the red zone (where the hospital falls below the 75th percentile in its hospital readmission rate compared to other hospitals), your arrival could literally cost them millions of dollars in penalties. Needless to say, hospitals are now scrambling to put programs in place to reduce hospital readmissions, all for the sake of “improved quality of care.” In summary:

“One in five Medicare inpatients is readmitted within 30 days. The Centers for Medicare and Medicaid Services (CMS) considers 40%-75% of these readmissions to be preventable. In October 2012, CMS will begin to track readmission and impose financial penalties on hospitals with higher–than–expected readmission rates for certain conditions. Other payers will certainly follow.”

So, will these programs to reduce hospital readmissions improve the quality of care you receive at your local hospital? Forgive me if I remain skeptical.

Are Tele-ICUs The Solution To The Critical Care Crisis?

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America’s ICUs are in crisis. Consider these staggering statistics: Today’s ICUs Serve 4 million patients annually, with roughly 20 percent mortality rates among those treated. On average, every patient admitted to the ICU suffers 1.7 potentially life threatening errors every day and estimates show that patients only receive half of the therapies that they should. And 50,000 patients annually die in the ICU from preventable deaths.

But research indicates that ICU patients have lower risks of death and shorter ICU and hospital stays when an intensivist is on duty in the ICU and oversees patient care. The mortality reduction has ranged from 15 to 60 percent lower than in ICUs where there are no intensivists. However, the Committee for Manpower for Pulmonary and Critical Care Services predicts a shortage of 10,000 ICU physicians, called intensivists, who have extra training to specialize in the care of the ICU patient. This   national shortage of intensivists makes it extremely difficult to find intensivists that can provide 24/7 care for today’s ICU patients.

The answer to solving this crisis has emerged from the world of telemedicine. Read more »

*This blog post was originally published at Medgadget*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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